Child undernutrition in Sub-Saharan African countries: an investigation of limitations of current approaches and recommendations for change


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Lufumpa, Nakawala Lyapa (2021). Child undernutrition in Sub-Saharan African countries: an investigation of limitations of current approaches and recommendations for change. University of Birmingham. Ph.D.

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Childhood undernutrition is of high public health significance, particularly within Sub-Saharan Africa. Undernutrition in childhood leads to impaired cognitive and physical development, poor academic performance, and decreased future economic productivity. Although significant efforts have been made to address child undernutrition in Sub-Saharan Africa, high levels of undernutrition persist. This thesis, a multi-methods study, goes beyond existing literature and policy to identify opportunities to accelerate the reduction of child undernutrition in Sub-Saharan African countries.

The first empirical chapter examines trends and inequalities in the prevalence of childhood undernutrition in African countries between 2000 and 2019. Notably, this study quantifies changes in the levels of childhood undernutrition in Africa and identifies subpopulations which could benefit from additional policy attention.

The second empirical chapter uses quantitative methods to investigate the association between exposure to household air pollution, from solid cooking fuels, and childhood undernutrition in LMICs. Notably, this robust study examines the association in numerous scenarios and within subpopulations.

The third empirical and fourth empirical chapters detail the findings of a qualitative study conducted in Lusaka district, Zambia. The third empirical chapter examines and compares the perceived causes of childhood undernutrition, according to primary caretakers of children under five years old and healthcare providers. The fourth empirical chapter explores primary caretakers’ perceptions of and experiences with nutrition education, and perceived barriers and facilitators to clinically recommended behaviour changes.

Critically, the findings of this thesis underscore significant opportunities to accelerate the reduction of childhood undernutrition in Sub-Saharan African. This thesis has identified significant gaps and limitations within existing nutrition research and policies. First, this thesis has highlighted the value of incorporating wider determinants of undernutrition into existing research and policy. Second, this thesis has identified inadequacies in the implementation of nutrition policies and the provision of nutrition services in Lusaka district, Zambia. Presently, global nutrition policy focuses on improving WASH infrastructure and behaviour, treating severe acute malnutrition, and improving infant and young child feeding. While critical, the findings of this thesis suggest that, when implemented alongside current policies, addressing the gaps and inadequacies in existing research and policy could further accelerate the reduction of child undernutrition in Sub-Saharan Africa and place the continent on track to meet the 2025 Global Nutrition Targets for childhood wasting and stunting.

Type of Work: Thesis (Doctorates > Ph.D.)
Award Type: Doctorates > Ph.D.
Licence: Creative Commons: Attribution-Noncommercial 4.0
College/Faculty: Colleges (2008 onwards) > College of Medical & Dental Sciences
School or Department: Institute of Applied Health Research
Funders: None/not applicable
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
R Medicine > RJ Pediatrics > RJ101 Child Health. Child health services


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